Gestational Trophoblasitic Disease Diagnosis
If you have symptoms of GTD, your doctor can do several things to find out why. The first is take your medical history and perform a physical exam. The exam will include a pelvic exam.
During the pelvic exam, the doctor will feel your vagina, rectum, and lower abdomen for lumps. The doctor will also “size” your uterus. That means your doctor will compare how big it is compared to how big it should be at that point in your pregnancy. Also, the doctor will check your ovaries. The doctor will do this to determine whether there are large cysts that typically are seen with GTD. The doctor may also order additional tests, including:
- hCG Level. Human chorionic gonadotropin (hCG) is a hormone that is made from a normal placenta and from GTD. If you are pregnant or if you have GTD, you will also have hCG in your blood and urine. If you have GTD, the level of hCG in your blood and urine will likely be higher. This hormone is very helpful to follow after treatment starts. It should disappear with successful treatment.
- Ultrasonography. An ultrasound is used to make sure a diagnosis of GTD is correct. Ultrasonography uses sound waves to form a picture called a sonogram. These echoes sound different for benign tumors than for cancerous ones. A special computer transforms the echoes into images. Then they can be viewed on a screen.
- Other Radiology tests. If the doctor suspects that GTD is invasive or metastatic, he or she will ask for certain X-rays. These are needed to look for areas of cancerous spread. Often a chest X-ray will be done. This is to check for spread to the lungs. The lungs are the most common site for distant spread of the tumor. Chest CT (CAT scan) or CT of the brain, chest, abdomen and pelvis also may be done. These can detect if the cancer has spread to other areas of the body. Often these tests will be requested by an oncologist.